| NPI | 1710935101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2017011123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 090180) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-07-23 |